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No detailed description available for \"The Myth of Empowerment\".

Fifty years after John F. Kennedy's speech on mental illness and retardation, E. Fuller Torrey's book provides an insider's perspective on the birth of the federal mental health program. Torrey draws on his own first-hand account of the creation and launch of the program as well as extensive research, one-on-one interviews with those involved, and recently unearthed audiotapes of interviews with major figures involved in the legislation.

Elizabeth Packard's story is one of courage and accomplishment in the face of injustice and heartbreak. In 1860, her husband, a strong-willed Calvinist minister, committed her to an Illinois insane asylum in an effort to protect their six children and his church from what he considered her heretical religious ideas. _x000B__x000B_Upon her release three years later (as her husband sought to return her to an asylum), Packard obtained a jury trial and was declared sane. Before the trial ended, however, her husband sold their home and left for Massachusetts with their young children and her personal property. His actions were perfectly legal under Illinois and Massachusetts law; Packard had no legal recourse by which to recover her children and property. _x000B__x000B_This experience in the legal system, along with her experience as an asylum patient, launched Packard into a career as an advocate for the civil rights of married women and the mentally ill. She wrote numerous books and lobbied legislatures literally from coast to coast advocating more stringent commitment laws, protections for the rights of asylum patients, and laws to give married women equal rights in matters of child custody, property, and earnings. Despite strong opposition from the psychiatric community, Packard's laws were passed in state after state, with lasting impact on commitment and care of the mentally ill in the United States._x000B__x000B_Packard's life demonstrates how dissonant streams of American social and intellectual history led to conflict between the freethinking Packard, her Calvinist husband, her asylum doctor, and America's fledgling psychiatric profession. It is this conflict--along with her personal battle to transcend the stigma of insanity and regain custody of her children--that makes Elizabeth Packard's story both forceful and compelling.

It is unclear whether risk for major depression during the menopausal transition or immediately thereafter is increased relative to pre-menopause. We aimed to examine whether the odds of experiencing major depression were greater when women were peri- or post-menopausal compared to when they were pre-menopausal, independent of a history of major depression at study entry and annual measures of vasomotor symptoms (VMS), serum levels of, or changes in, estradiol (E2), follicular stimulating hormone (FSH) or testosterone (T) and relevant confounders. Participants included the 221 African American and Caucasian women, aged 42-52 years, who were pre-menopausal at entry into the Pittsburgh site of a community-based study of menopause, the Study of Women's Health Across the Nation (SWAN). We conducted the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) to assess diagnoses of lifetime, annual and current major depression at baseline and at annual follow-ups. Psychosocial and health factors, and blood samples for assay of reproductive hormones, were obtained annually. Women were two to four times more likely to experience a major depressive episode (MDE) when they were peri-menopausal or early post-menopausal. Repeated-measures logistic regression analyses showed that the effect of menopausal status was independent of history of major depression and annually measured upsetting life events, psychotropic medication use, VMS and serum levels of or changes in reproductive hormones. History of major depression was a strong predictor of major depression throughout the study. The risk of major depression is greater for women during and immediately after the menopausal transition than when they are pre-menopausal.

ObjectiveTo compare reproductive history and postmenopausal health by birth status (preterm vs. full term) in a U.S. longitudinal study of postmenopausal women. Birth status was examined according to region of residence, household, and neighborhood socioeconomic status (SES).MethodsIn the Women’s Health Initiative Observational Study, 2271 women were born prematurely (< 37 weeks). ANOVA and Chi-square determined birth status differences of reproductive history, pregnancy, and postmenopausal health. Odds ratios were calculated using either binary logistic or multinomial logistic regression. SES and U.S. region of residence were examined as potential effect modifiers.ResultsPreterm-born women compared to term-born women had higher risk of delivering a premature infant (aOR 1.68, 95% CI [1.46, 1.93]), higher odds of later-age first pregnancy (aOR 1.27 95% CI [1.02, 1.58]), longer duration to become pregnant (> 1 year to pregnancy) (aOR 1.10 95% CI [1.01, 1.21]), more miscarriages (aOR 1.23 95% CI [1.11, 1.37]), and more pregnancy complications including hypertension (aOR 1.58 95% CI (1.13, 2.21)], preeclampsia (aOR 1.64 95% CI [1.24, 2.16]), and gestational diabetes (aOR 1.68 95% CI [1.11, 2.53]). Preterm-born women had higher odds of menopause before age 50 (aOR 1.09 95% CI [1.05, 1.14]). Post-menopause, they had higher rates of diabetes (p = .01), hypertension (p = .01), hysterectomy (p = .045), and higher Charlson Comorbidity Index scores (p = .01).ConclusionsPreterm-born women had higher reproductive and pregnancy risks which when coupled with early menopause, may indicate a shorter childbearing period than term-born women. Guidelines for integration of preterm history in women’s health care across the life course are needed to identify and manage their higher risk.SignificanceWhat is known?Preterm-born individuals have an array of poorer outcomes as adults including cardiovascular, metabolic, renal, respiratory disease, mental health conditions, worse neurodevelopment, and difficulty reaching adult milestones. Yet, little is known about the effect of preterm birth on women’s reproductive health—preconception through menopause and beyond.What the study addsThis examination of lifelong reproductive health highlights the higher risk for preterm born women calling for the integration of prematurity history in primary and women’s health care.

Paul Gionfriddo's son Tim is one of the \"6 percent\"—an American with serious mental illness. He is also one of the half million homeless people with serious mental illnesses in desperate need of help yet underserved or ignored by our health and social-service systems. In this moving, detailed, clear-eyed exposé, Gionfriddo describes how Tim and others like him come to live on the street. Gionfriddo takes stock of the numerous injustices that kept his son from realizing his potential from the time Tim first began to show symptoms of schizophrenia to the inadequate educational supports he received growing up, his isolation from family and friends, and his frequent encounters with the juvenile justice system and, later, the adult criminal-justice system and its substandard mental health care. Tim entered adulthood with limited formal education, few work skills, and a chronic, debilitating disease that took him from the streets to jails to hospitals and then back to the streets. Losing Tim shows that people with mental illness become homeless as a result not of bad choices but of bad policy. As a former state policy maker, Gionfriddo concludes with recommendations for reforming America's ailing approach to mental health.

Three decades ago, Grove introduced his sex-role theory of mental illness, which attributes women's higher rates of psychological distress to their roles in society. Central to his hypothesis is that marriage is emotionally advantageous for men and disadvantageous for women. This article revisits this topic with data from the National Survey of Families and Households. The analyses indicate that the emotional benefits of marriage apply equally to men and women, but that men and women respond to marital transitions with different types of emotional problems. The implications of these findings for future research on gender and mental health are discussed.

Examining women veterans’ self-reported mental health is critical to understanding their unique mental and physical health needs. This study describes self-reported mental distress over a 17-year period among cross-sectional nationally representative samples of women in the USA using data from the Behavioral Risk Factor Surveillance System (BRFSS) core national surveys from 2003 to 2019. Nationally representative prevalence estimates of self-reported mental distress were compared between women veterans and their (1) men veteran and (2) women civilian counterparts. In each year examined, women veterans report significantly more days of recent mental distress and significantly higher prevalence of frequent mental distress than their men veteran counterparts. In several years, women veterans also report greater levels of recent and frequent mental distress than women civilians. These findings highlight the long-standing high prevalence of self-reported poor mental health among women veterans and suggest that specific efforts to address mental health among women veterans as a unique population may be warranted.

Previous research suggests that sexual minority youth have poorer health-related outcomes than their heterosexual peers. The purpose of this study is to determine whether sexual orientation disparities in mental health and substance use increase, decrease, or remain the same during the transition from adolescence to adulthood. Data are from Waves 1–4 of the National Longitudinal Study of Adolescent Health ( n  = 8,322; 55% female). Respondents were in grades 7–12 at Wave 1 and aged 24–32 at Wave 4. Latent growth curve modeling is used to compare the mental health and substance use trajectories of youth who consistently report heterosexual attraction versus those who consistently report lesbian, gay, or bisexual (LGB) attraction, those who report a transition to LGB attraction, and those who report a transition to heterosexual attraction. Among women and men, sexual orientation disparities in depressive symptoms and suicidal thoughts persist, but do not increase, during the transition from adolescence to adulthood. The same pattern is observed for disparities in smoking, heavy drinking, and marijuana use among women. Among men, disparities in substance use are only observed between those who report consistent heterosexual attraction and those who transition to heterosexual attraction. Disparities between these groups persist over time for heavy drinking and marijuana use but decrease over time for smoking. While this study finds evidence of numerous disparities in mental health and substance use outcomes during adolescence and young adulthood, particularly among young women, there is no indication that these disparities get larger over time.

Drawing from Race-Based Traumatic Stress theory, the present study examined whether traumatic stress and depressive symptoms differentially help explain the relation between racial/ethnic discrimination and suicidal ideation across gender and racial/ethnic groups. A racially/ethnically diverse group of emerging adults (N = 1344; Mage = 19.88, SD = 2.25; 72% female; 46% Hispanic) completed a battery of self-report measures. A cross-sectional design was employed with a series of hierarchical linear regression models and bootstrapping procedures to examine the direct and indirect relation between racial/ethnic discrimination and suicidal ideation through traumatic stress and depressive symptoms across gender and race/ethnicity. The findings suggest an indirect relation through depressive symptoms, but not traumatic stress, and a serial indirect relation through traumatic stress to depressive symptoms in young women and young men, the latter of which was stronger in young women. The indirect relations did not vary by racial/ethnic group. Cumulative experiences of racial/ethnic discrimination may impact suicide-related risk via increases in psychiatric symptomology (i.e., traumatic stress and depressive symptoms), particularly in young women. Racial/ethnic discrimination experiences should be accounted for as a potential source of psychological distress in the assessment, diagnosis, and treatment of suicidal thoughts and behavior, especially among young women endorsing traumatic stress and depressive symptoms. Further research is warranted to better understand the gender difference in the relation between racial/ethnic discrimination and suicide-related risk.